Provider Demographics
NPI:1689660219
Name:WORK RECOVERY CENTER
Entity Type:Organization
Organization Name:WORK RECOVERY CENTER
Other - Org Name:PARKWAY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-760-1520
Mailing Address - Street 1:1597 LEHIGH ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-3813
Mailing Address - Country:US
Mailing Address - Phone:610-791-3801
Mailing Address - Fax:610-791-4851
Practice Address - Street 1:421 S BEST AVE
Practice Address - Street 2:CORPORATE OFFICE
Practice Address - City:WALNUTPORT
Practice Address - State:PA
Practice Address - Zip Code:18088-1217
Practice Address - Country:US
Practice Address - Phone:610-760-1520
Practice Address - Fax:610-760-1721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA905527Medicare PIN